Iraq Told Civilians to Stay in Mosul. Now They’re Paying With Their Lives.

MOSUL, Iraq — By the time little Amira, just a year old, reached the field clinic near the front line in Mosul, she was already dead. All her father could do was bundle her up in a golden blanket, carry her to a nearby mosque and bury her.

When a Humvee pulled up to the door of the clinic, a young boy in the back was draped over a man’s body. “My father, answer me!” he cried. “My father, answer me! Don’t die!” But he, too, was already dead.

It was barely noon on Wednesday, and eight bodies had already arrived at the clinic, an abandoned house where medics provide a minimum of treatment, just enough to keep the lucky ones alive long enough for the hourlong drive to a trauma center.

The battle for Mosul, which started six weeks ago, aims to evict the Islamic State from its last major stronghold in Iraq. But civilians are paying a growing price, with more and more dead flowing out of the dense, urban combat zones each day.

The carnage, along with significant military casualties, has prompted some military officials to second-guess their initial strategy, which asked residents to stay in their homes and rise up against the Islamic State. There has been no uprising, and civilians are dying at home, all of which is fueling concern that the campaign could become a quagmire.

The Iraqi authorities are also considering greater firepower. But introducing new weapons that may be more effective against Islamic State fighters, like artillery and tanks, also risks putting civilians in even greater danger.

For now, most of the civilians killed are casualties of Islamic State artillery and snipers, soldiers say. The rising civilian toll has ground the fight to a crawl, as Iraqi forces are unable to make substantial progress and protect civilians at the same time. The government is considering a mass evacuation, but even that might make civilians more vulnerable if the Iraqi military were to change its tactics.

A boy held the body of his father, who was killed by an Islamic State sniper, at a field hospital on the outskirts of Mosul.CreditSergey Ponomarev for The New York Times

In a bid to regain some momentum, the American-led coalition on Wednesday bombed another bridge over the Tigris River in Mosul, leaving only one intact. The goal is to prevent the Islamic State, also known as ISIS or ISIL, from resupplying its forces in east Mosul, where Iraqi forces have bogged down.

Humanitarian workers, already fearing a siege of Mosul’s city center that could drag on until the spring, are drawing up plans for airdrops or sending food into the city on boats up the Tigris.

“What we’re seeing is terrifying,” said Lise Grande, the top United Nations humanitarian coordinator in Iraq. “ISIL is intentionally targeting civilians, firing directly at them. Scores of people, including young children and women, are arriving daily in hospitals. Their injuries are horrific. The wounded are traveling for hours to reach proper care.”

She said that if the Iraqi security forces start using heavy artillery, “there is no doubt civilian casualties will increase exponentially.”

“We cannot rule out that Daesh will push people into the firing zone,” she added, using the Arabic acronym for the Islamic State. “The result would be catastrophic.”

Many are questioning the wisdom of the Iraqi government’s decision, before the battle began, to drop millions of leaflets over the city imploring civilians to remain in their homes. The objective was to avert a humanitarian crisis set off by hundreds of thousands of civilians fleeing, but instead civilians are increasingly dying as they are caught in the crossfire while soldiers make their way, house by house, through densely populated neighborhoods.

“The problem is all the civilians,” Brig. Gen. Fadhil Barwari, a special forces commander, said in an interview. “I can’t use my tanks, I can’t use my artillery.”

Another problem is that the pre-battle intelligence the Iraqis relied on was wrong. Iraqi intelligence officers had predicted that once security forces reached Mosul, civilians, including tribal fighters who had been feeding information about the Islamic State from inside, would rise up, and that the city would fall quickly.

A relative carried a boy wounded in shelling by the Islamic State to the field hospital.CreditSergey Ponomarev for The New York Times

Brig. Gen. Abdul-Wahab al-Saadi, another special forces commander, said he had known from the beginning that no one would rise up.

Iraqi officials had hoped that keeping civilians in their homes while counting on residents to rise up would also avert the type of destruction in Mosul that was seen in Ramadi, another Islamic State-held city, which was liberated at the beginning of the year but was reduced to rubble. Now, as military officials consider whether to try evacuation to allow a greater use of artillery and more airstrikes, they worry that Mosul, too, could look like Ramadi once the battle is finished.

Amid the chaos on Wednesday, as the bodies were flowing into the field clinic, Lt. Gen. Stephen J. Townsend, the top American military commander in Iraq, landed in a helicopter to meet with the Iraqi officers leading the battle. One, Brig. Gen. Sami al-Aridhi, said that at the emergency meeting, the Iraqis implored the Americans to do more to target Islamic State artillery positions and car bombs from the air.

“The Americans promised us today they would send more drones,” he said.

He also said the government should shift tactics and order civilians to leave their homes, even though in some neighborhoods where Iraqi forces have tried to evacuate families, the civilians have refused, saying they do not want to live in tent camps.

“We have tried so hard not to harm them,” he said.

At the field clinic in Mosul on Wednesday morning, trucks and Humvees arrived one after the other, carrying the wounded and dead. Medics said they needed more of everything — bandages, antibiotics, fluids for IV drips. “It gets worse every day,” said an Iraqi colonel who gave only his first name, Khalil. “There are lost legs, chest wounds, head wounds. Daesh has begun to target the people.”

Adding to the chaos, groups of civilians fleeing the fighting are constantly approaching the clinic, setting the soldiers scrambling to keep them away, rifles raised, out of fear of suicide bombers. On Wednesday, one man, insistent on reaching the soldiers, stopped in the distance and raised his gown to show that he was not strapped with explosives.

After a first stop at the field clinic, many of the wounded go to Erbil, the Kurdish capital, where trauma centers and hospitals are overwhelmed and running low on medicine and other supplies. There are also not enough doctors, and those working have not been paid for months because of a financial crisis brought on by low oil prices.

“It’s 24 hours a day,” said Dr. Hassan Mercalose, 29, who works at West Hospital in Erbil. The last time he was paid was in August, and that was only 30 percent of his salary. With fighting intensifying in Mosul, he said, “the situation is going to get worse. I know that.”

A civilian in Mosul on Wednesday showed a member of the security forces that he was not wearing a suicide vest.CreditSergey Ponomarev for The New York Times

On Tuesday night, nearly every room was full of civilians who had been hurt in Mosul. The halls were filled with patients on gurneys, awaiting surgery.

In one room was Khalid Majid, 40, whose 5-year-old son, Hamoudi, was killed that morning in an explosion in Mosul and whose wife, with back wounds from the same explosion, was lying on her stomach and crying out for her son.

“This is the problem with the government,” Mr. Majid said. “They asked us to stay home and this is the result. It’s not just me. There are so many families.”

Upstairs in Room 218 was Rahma Idriss, a 16-year-old girl who had just lost both of her legs. It was especially tragic, her family said, because she was not married and now no one would want to be her husband.

Down the hall was her brother Farris, 42, who lost his left leg in the same attack that wounded her. He had a smile on his face and warmly welcomed a visitor, which is normal for Iraqis. Even under the saddest of circumstances, the hospitality they are famous for shines through. He said he had showed up in just his underwear, and had no pillow until a friend gave him one.

“We were brought up in great families,” he said. “This forced us to be generous, and to deal with people in a good way.” He said that even the foreign Islamic State fighters who lived in his neighborhood were “surprised when they saw our traditions.”

Downstairs at the hospital, Mohammed Abdulmunum, 53, stood in a hallway and ticked off his losses that day — four family members killed, his wife wounded and probably paralyzed, his house destroyed — and then turned philosophical.

“I have lost all of my life,” he said. “There is nothing more to be afraid of.”